Farewell Indian Summer

19. March 2008

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Does the additional dose of testosterone make the potent man in his sixties? At any rate the hormone therapy is popular with older men. A study made in the Netherlands shows now: By far not all that glitters is gold on the anti-aging-bazaar!

Not always do dreams come true: “If research is successful, people will not just get old but stay healthy”. By the mid of this century we will have more old than young people. More men and women over age 65 than under age 15, as Richard Faragher, biologist and age researcher at the University of Brighton, estimates. For several years scientist and anti-aging marketing people are dreaming about how hormones put a stop to the aging process and 70 year old guys look and feel like men in their best years. Results of a clinical research group at the Utrecht University now seriously disturbed that illusion. Data in the professional magazine JAMA shows, that the effects of testosterone are a far cry from what the participants expected.

Time and again, anti-aging specialists kept looking at the results of a testosterone therapy on older men over the past years. Up to know the studies were laid out rather small considering only few aspects of the aging process: bone- and muscle mass or brain performance. Different targets and design of the examinations did not allow a reliable evaluation of a testosterone therapy for men.

Bad news for hormone fans

Marielle Emmelot-Vonk and her team of researchers now examined 223 men beyond their sixties regarding body mass and their percentage of fat, cognitive performance, muscle mass and -strength as well as flexibility after a six-months therapy of 160mg testosterone per day. All participants suffered from a Hypogonadism due to age with an average testosterone contents of 11.0 respectively 10.4 in the placebo group. After half a year, the level of the free or bonded hormone was not any higher than in the beginning, although the fat-free body mass increased the same level as the percentage of fat got lower. But the studies also showed: The change in body proportions did not automatically lead to more strength in arms and legs. And the mineral content of the bones hardly changed as well after six months. Director of studies Yvonne an der Schouw has even more bad news for physicians trying to rejuvenate their patients with hormones: “We had hoped that the intraabdominal percentage of fat would go down, because this is where the dangerous fat of the body is. But we did not find any changes there either.” The HDL-cholesterol dropped significantly compared to LDL and triglyceride. This was the main reason why Emmelot-Vonk and her colleagues registered that the number of test persons using the alleged hormone treatment turning into patients with metabolic syndrome increased compared to those using the placebo drug.

Male climacteric period – just a urban legend?

After those test results it for sure will get harder to market a hormone replacement therapy for men beyond their fifties. The term “male climacteric period” is vanishing from the advertising slogans for ant-aging products. But there are also hot discussions about the frequency of Hypogonadism in older people and a more or less necessary treatment with the sexual hormone. Via questionnaire Antti Perheentup was looking for participants suffering from a Hypogonadism to join a Finnish testosterone study. Among the 16,000 returns, 2,500 had the according symptoms. After blood analysis only 37 suitable candidates remained – by far too few for statistics and much less than the circulated figures of about 20 percent of all men with a testosterone deficit. The fertility physician Eberhard Nieschlag at the Münster University confirmed the observation of Perheentupa in the Spiegel-Online: “About 90 percent of all men in their sixties and more than two third of all 80-year old men have enough testosterone in their blood.” If anything, the results of the Dutch might cause a reconsideration of a German guideline on testosterone treatment of 2001. The consensus paper of several urologists’ associations stipulates hormone administration under 8 nmol/l, under 12 nmol/l it at least provides for the option for such a treatment.

Old folks – an obsolescent model

The discussion about sense and nonsense of an anti-aging therapy with hormones is nowhere near a conclusion as it looks right now. Manfred Römmler, Senior Executive of the German Society of Anti-Aging Medicine and author of a book “Die Wahrheit über Hormone (the truth about hormones)”, speaks for a “therapy for seniors by balancing a potential hormone deficiency with natural hormones”. Manfred Stöhr, former director of the Neurological Hospital in Augsburg has a completely different point of view. In his book “Die Wahrheit über Anti-Aging (the truth about anti-aging)” he writes: “We should learn to understand age as a physiological phase of life and we certainly should not define the older person as an obsolescent model which can only be helped by an all-around renewal in a hormonal fountain of youth”.

Marielle Emmelot-Vonk at least advises those patients who had expected more from taking testosterone to take something that increases low hormone levels as well: Healthy food and sports.